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Ron Tester @rontester

Growth Strategist & business coach. 25 yrs a service biz owner (sold for 7 figs). 10 yrs coaching service pros to break plateaus. rontestercoaching.com

Joined September 2009
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Ron Tester@rontester
9 Apr 2024
Hi there, I'm Ron. I'm all about helping people who run their own businesses—like you—get past tough spots and hit their goals while keeping their personal lives balanced. I've been in your shoes, so I get it. #Coachingsuccess #coachingsuccess #solopreneurlife #businesscoaching
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"I didn't pay myself last week so the staff could get paid." I hear it from owners more than you'd think. It means the model isn't covering the real payroll, yours included. Treat your own salary as a bill the clinic owes, not a leftover.
An owner asking "how do I work harder" ends up treating more patients. An owner asking "what does the clinic actually need" ends up fixing intake, the front desk, or the payer mix. Only one of those still pays off a year from now.
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"We all help out" is a great response to a busy day. It's a poor staffing strategy. If the same non-clinical work keeps landing on clinicians, there's usually a role missing somewhere in the design.
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A therapist finishes a double-booked afternoon, wipes the tables, folds the laundry, takes out the bathroom trash, covers the voicemail, then gets asked to plan the staff birthday lunch. None of those is outrageous by itself. The problem is when this becomes the staffing plan.
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Director admin time needs a job. Hiring. Mentoring. Chart review. Physician relationships. Block the time first. Then decide how you'll know it was used well.
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Documentation gets easier to manage when the standard is specific. "Do your best" is not specific. "Notes are done the same day as the visit" is. Clinical judgment works the same way. If the team has to guess what good looks like, the standard is still in your head.
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Want fewer hallway questions about hard cases? Write down the last five your team brought you. Sort them: refer back, ask a peer, talk to the patient, change the plan, pull in the supervisor. The category that repeats is the one to write down first.
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A clinician brings you the same kind of question three times in a month. That isn't neediness. It's a gap. The clinic never agreed on what to do when a case is unclear, so it routes to you by default. Agree on it once, with the team, and it stops coming back to you by default.
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To a new grad, your senior clinician's judgment looks like instinct. It isn't. It's a sequence she has run so many times she stops noticing the steps. Your job is to slow it down enough that someone else can see it.
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The strongest recruiting line may not be a higher number. It may be a specific picture of year one. Who mentors them. How the caseload ramps. What "good" looks like here. When they get real autonomy. Specifics recruit. Slogans don't.
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A candidate carrying six figures of debt is doing real math. They aren't testing your values. You can't erase the loan. You can be honest about what the job pays, what it offers besides pay, and where it leads. That beats a culture pitch.
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You can't outpay the hospital if you don't know what your clinic can afford. Before you build the next offer, know your dollars per visit by payer. More volume on a rate you haven't checked doesn't create margin. It just gives you more visits with the same problem.
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A candidate said the problem at their last job was volume. You offered lower volume. They left after six weeks anyway. Interview for the problem they're leaving, not just the job they say they want next. Lower volume doesn't fix burnout with the profession itself.
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"We have a great culture" is what every clinic says. Candidates have heard it everywhere. Development is more concrete. A schedule that doesn't grind is more concrete. A mentor who sits with them after a hard eval is more concrete. Recruit on the specific, not the slogan.
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If your offer is better than the salary number makes it look, show it before the candidate has to ask. Put it on one page: salary, PTO, taxes you cover, match, CE, loan help, mentorship hours, bonus. Total at the bottom. Build that page before your next interview.
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The candidate isn't comparing your clinic to your values statement. They're comparing your offer to rent, debt, commute, schedule, burnout risk, and the future they can picture from where they sit. Speak to those, or the salary number carries the whole decision.
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A private clinic usually can't outpay student debt or hospital salaries. So don't make the salary number carry the whole offer. Show the rest: mentorship that actually happens, a schedule that doesn't grind, a clear first year, and a next step they can see.
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A productivity bonus won't keep a clinician who can't see a future in the role. Money answers "am I paid fairly." It doesn't answer "where am I going." Get the path right first. The incentive works better sitting on top of a reason to stay.
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People don't need an unlimited future to stay. They need an honest one. Tell a good clinician where the role can go, and where it can't. Most will respect the straight answer more than a vague promise. The side-hustle question is often just: is there a next step here, or not?
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Not every great clinician should become a manager. Not every loyal one stays forever. Name the ceiling without making them wrong for reaching it. Avoiding the ceiling conversation doesn't protect retention. It just delays the exit.
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